Extractions are required for a number of reasons, but most commonly when there is pain from severe dental decay, trauma, gum disease, orthodontic reasons or impacted wisdom teeth. Simple extractions are performed under local anesthetic, although anxious/nervous patients may be offered oral sedation as well. In some cases, where the dentist feels the extraction may be more difficult, e.g. impacted wisdom teeth, severely broken teeth, an initial consultation may be required. This will be to plan and discuss the best approach from a technical point of view, as well as to book the necessary appointment time.